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Depression

Dissociation

by Kristina Randle, Ph.D., LCSW
written by Kristina Randle, Ph.D., LCSW

I have been seeing a psychologist for past 2 years weekly. I have suffered from depression and 2 years ago attempted to take my own life. I recovered physically but still everyday is a struggle. I have become isolated, rarely go out only to attend work and prefer this way. I have an adult son who treats me poorly, has been physically and psychologically abusive since he was a teenager, have 3 grandchildren but only see one of them now.
My psychologist thinks I suffer from complex trauma due to childhood abuse from my mother, sexual abuse from my brother, was in a domestic violence with my sons until he took his own life, found closest friend who took her own life, it just goes on and on. How do I recover from this?

Sometimes I don’t know if things really did happen or have I dreamt it happened. I feel like I am losing my mind. I don’t know what to do. I feel like a failure, couldn’t even take my own life right. Please help.

Thank goodness you did not die. Your having failed was a success, a blessing in fact. In addition, had you died your family and friends would have suffered a tremendous loss. Imagine, for a moment, the suffering of your grandson had you succeeded. You spared him from having to lose his grandmother. It reminds me of what Scott Simon of NPR tweeted about losing his grandmother to suicide: “My grandmother took her life and my mother, who struggled against the impulse several times, said, ‘Suicide puts a fly in your head. It’s always inside, buzzing around.'”

Maybe your “failure” saved your grandson and others in the family from having to endure the “buzzing” of suicide.

You might try reading about people who attempted suicide but survived. The vast majority of them did get help and were thankful to have survived. The most famous among them may be Kevin Hines. He jumped from the Golden Gate bridge. The second his hands left the rails he felt instant regret. He survived, got help and now shares his story of hope and change. His story is a testament to the fact that life circumstances change.

You might also try reading about near death experiences (NDEs) or watching testimonials on YouTube. The International Association for Near Death Studies (IANDS) is one of the best resources. People who have had an NDE are often profoundly affected. It significantly changes the way they live and view the world. One particularly inspirational NDE was that of Jeffry Olsen. Reading about NDEs or watching IANDS videos might positively change your view of life and death.

You have been in therapy for two years but you did not indicate if it was helping. You should feel a little better after each session. If not, you might need a new therapist. The idea of a new therapist can be dispiriting for some people because they don’t like the idea of starting over but sometimes a change is needed. It may be necessary for you.

Life is difficult. That is undeniable. Everyone struggles, some more than others. We must learn to endure it. I understand that you are suffering and for that I am immensely sorry, but it is a fallacy to believe that your life will not improve. I sincerely believe it can. It is often a matter of finding the right treatment. Think about whether a new therapist is right for you and make the change if necessary. Call emergency services if you feel that you can’t protect yourself. Good luck.

Dr. Kristina Randle

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Anxiety Problems But Scared to Tell My Parents

by Kristina Randle, Ph.D., LCSW
written by Kristina Randle, Ph.D., LCSW

Hello! I’m struggling for now 4 years without telling it to anyone. I’m just not happy and I’m done feeling like this. I always thought that that was just a phase and it would go away with time but everything got worse when I entered middle school, I started having strong body image issues, I even got an eating disorder for two years. But since summer 2015, I kind of controlled this eating disorder and I’ve been eating “normally” since. But throwing up every time I was eating was my way to feel like I was in control, but since I tried to recover from it, I feel like I have nothing in control, so I found this feeling of control in self-harm but my anxiety got even worser. It became so unhealthy that it has an impact on my physical health. I’m not trying to get a diagnosis but just some advices on how to talk to my parents (that know absolutely nothing about it, they just think I’m someone very nervous) even if I know that it would tear them apart to know that I self-harmed and how bad I feel. Or is there a way to make them subtly understand that something’s wrong without directly going to them? Thank you very much for reading this!

You are doing the right thing if you ask for help. It is a mistake to wait. The wait is over if you decide it is. It is time to ask for help.

Be honest with your parents about what’s wrong. They need to know the truth so that they can assist you with finding the right type of treatment. You can also tell them that you have consulted a licensed professional at Psych Central who has recommended the consideration of mental health treatment. Your parents should also know that your symptoms are highly treatable with counseling and medication.

Your parents might feel bad about your having had suffered for years but it will not “tear them apart.” They only want you to be healthy and happy. They will be happy to know that with some intervention you will be once again be the healthy, happy daughter that they want you to be. They love you and won’t like the idea of your suffering now or for the past few years but imagine how much worse it would be for them to know that you would suffer for more years, simply because you were afraid to ask for their help. You have the power to make a positive change in your life right now by asking for help. Utilize your personal power and seek help for your very curable set of problems.

Keeping this information from your parents will only prolong your suffering and ultimately theirs. There is no shame in seeking mental health treatment. Is there shame in seeing your dentist? It is no different.

Once you begin treatment, you will see just how helpful it can be. Good luck and please take care.

Dr. Kristina Randle

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Might Having Children Fill the Void I Feel?

by Kristina Randle, Ph.D., LCSW
written by Kristina Randle, Ph.D., LCSW

Q. I have notice a sudden change in myself and I am very concerned. I have noticed a sudden change in my behavior and thoughts, I am concerned about my well being. During my childhood I can remember my mother in and out of the hospital several, several times for things like Bi-Polar Disorder, OCD, Depression w/ the suicidal thoughts. My sister has a handful of of these problems as well. They are both on medication. I have always been able to manage my issues outside of a doctors office. I have been to couseling but I did not care for it. I felt like all I was doing was whining and not getting anywhere. I was a teen then anyways. I realize now that teens are just dramatic in general.

This past month or so I feel like my mind is in a fog. I have lost my abilty to concentrate on things, I am forgetfull and I seem to be more emotional about things. I feel like I just woke up one day and became more aware of everything going on. I have never been married and I have no children. This is a big issue to me. It can sometimes consume my mind for hours. My boyfriend is older than I and he has had a vasectomy. We are working on getting it reversed. I am ready for a child. I’m terrified to think that this procedure will fail. Then What…what will I do? This thought caused lots of stress. It’s getting to the point where I find myself jealous of my friends that are already mothers. I get attached to their children as if they were my own. I feel like not having a child is causing a huge void in my life. I’m ready to grow up. I want a family. I feel guilty for being jealous. I don’t know why but these feelings I have about having a baby are getting stronger and stronger. It’s hard for me to hold it together and talk about how bad I want a baby. My mother wants me to have one too. She at one point was putting lots of pressure on me about this. She quit when I told her how sensitive I was to this subject.

Now I am terrified that something will happen to my mother and she will never have a opportunity for me to give her another grandchild(my sister has two children). I don’t want to feel like I let my mother down if something happens to her and I am with child.

I also have issues with my only sister. We do not get along. This stems from her having to raise me during her teenage years. She told me at one point that she could not help but resent me for that. My mom juggled more than one job trying to provide for us. My sister had to give up a lot of her teen times to watch me, the little sister that was oh so un-expected. She told me all about this whenever she was mad about something. It made me feel like she couldn’t stand me and that I was the reason for all the misery her life brought her. We did not have the same father. Her father left when she was about 9 and my father was a raging alcoholic who beat our mother. She always said he would leave us alone if I had never been born. I know that she said these hurtful things to me because she was hurt. She didn’t understand at the time and either did I, but these things she said to me have had an effect on me as an adult. Maybe I could let these things go but thats hard when our realtionship has never changed. We still do not get along. She always told me that I would turn out just like my dad, “a mean ol drunk”. When I became an alcoholic she was quite pleased that when the time came around her prediction was true.

My mother holds this family together. She always said that she wishes that my sister and I would get along because we will need each other when she is gone. We have a small family and I am the youngest. My aunts are in their 60’s and early 70’s and I have about 7 cousins that are in their late 30’s early 40’s. They all grew up and are close with my sister. I really have no family that I speak to other than mom. I fear that when she is gone I will be alone. I won’t have a soul. I think thats where my desire for a child kicks in. I need to start my own family because when my mother is gone I know that I won’t have much to do with anything anymore. I’m the alcoholic daughter (functioning alcoholic) that can’t be alone, and I feel like everything in life I want will never happen. I can’t think, remember little things, I feel like I just can’t do anything. Why has this hit me so hard all of the sudden. I can’t keep it together. I feel like I’m failing at life in generel. I wish I could get control and feel at peace.

You have a void in your life. That is what you said in your letter. You are currently trying to fill this void with a child. You used to and still are using alcohol to fill this void. Be assured that you cannot adequately fill this void with alcohol or a child.

You are suffering. Naturally, you are searching for something to make you feel better. Children can be a blessing but it is important that you examine why you want to have a child. Do you want to have a child for a legitimately psychologically healthy reason? It would not be healthy to have a child to ease your loneliness or as a way to make your life feel less empty nor would it be wise to have a baby because you want to please your mother. Having a baby may give you a temporary boost in happiness and you might feel less of the void you speak of but it will not solve your issues. The void would most likely return.

It also might not be fair to have a child for the reasons you specified. A child needs parents who are psychologically healthy. No one is perfect or issue-free but if you still have not resolved the issues you have been experiencing for many years, it might be difficult to raise a psychologically healthy child. It is important to consider these issues when you are thinking about bringing a child into this world. You might want to reconsider having a baby if you would be doing it simply to fill a void.

You went to therapy once and you did not like it. Maybe it did not work for you because, as you said, you were too young. Now may be different. Maybe now you are ready to work on your issues and get your life back.

You are depressed and something is amiss in your life. You are searching for something to make you feel better. I would suggest that you let a trained mental health professional assist you in this exploration process. I wish you luck and thank you for writing.

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Incorrectly Diagnosed?

by Kristina Randle, Ph.D., LCSW
written by Kristina Randle, Ph.D., LCSW

I wonder if I have been wrongly diagnosed. I have battled with my mental health for approximately 11years, Starting off with being diagnosed with chronic depression and post traumatic stress disorder after many years of bullying result in my being beaten up and put in hospital by the bullies. That was when I was 12 years old. As the years have progressed and I have matured I seem to have gone through many different illnesses.
1. Chronic Depression, PTSD and Anorexia Nervosa
2.Severe Depression,Anxiety and Anorexia Nervosa
3.Cyclothymia
4.Bipolar II
Recently I have been diagnosed with A-Typical Bipolar Disorder, Anxiety Disorder, Social Phobia and Recurrent Depressive Illness.

I am beginning to wonder if this recent diagnosis (and many of the past ones) is incorrect.
I have done a lot of researched about my symptoms traits etc and they seem to steer more towards Borderline Personality Disorder.
I will quickly explain me:
Usually I don’t know how I feel, people say “what’s wrong?” and I just don’t know.
I get flustered, and panic, mostly when things change, I don’t like change, I am often very disorganised, but don’t like it I am a very chaotic person.

I switch from one thing to another in a matter of minutes. I don’t like disorder, I think things to be right. I have a massive fear of abandonment, I always think my husband is going to leave me for someone “normal” someone “better”. I always second guess him and myself, my self – esteem is non existant, I have no confidence in anything I do. I don’t like being along, I don’t like doing things on my own, however sometimes all I want is to be left alone – I never know what I want!
I’m sad all the time and want to cry, soemtimes I think people are all against me and are purposly trying to upset me. I have no interest in most aspects of life. I don’t have any friends, or what I was class as “friends” I have being in crowds, I feel closed in and I can hear the blood pumping in my ears.

I’m all over the place. I Spend ridiculously..Usually stuff we/I don’t need but want to make me feel better…My sleep is all over the place..Sometimes I don’t want to sleep and it takes forever to go to sleep but then when the morning comes I don’t want to get up. I eat because I have to (my family make me!) My biggest problem is I’m good at hiding things, I have spent many years putting on a front and seeming “happy and ok” that I don’t know how to be “ME” the real me..I self harmed for nearly 10 years..and the only reason I don’t now is knowing how much it hurts my family…My CPN and Psychiatrist said this shows that my condition is no serious as people who were serious would not be able to control this. But I don’t want to control it, I want to be me and not live up to everyone else’s expectations…I am who I am to suit my family, not to suit me. I hide everything, and to be honest I don’t know how to be me….I have wierd thoughts that no one else seems to understand, I ask daft questions. I hate myself and everything about me. I think I’m worthless and pathetic and that there’s no point to my life. Oh I don’t know I just can not explain anything about me how I feel or anything I just don’t think that I don’t fit in with the Bipolar spectrum..I do have anxiety I know this and I am pretty sure on the Recurrent depressive illness…and as for the social phobia well that could be right….the other problem I have is I don’t know how to say to my psychiatrist I think he is wrong, afterall he’s the professional and in my experience with alot of professionals they don’t seem to care about your opinions only theirs and that what they think is correct…I’m all over the place I just don’t know what to do…I’ve gone from being on 600mg Lamotrigine,5mg Aripiprazole and 2mg Diazepam to 20mg Fluoxetine (with a 12month gap in between when I was pregnant and not on any medication) PLEASE HELP I don’t know where to go or what to say or anything..

Typically I try to steer people away from focusing on a diagnosis. For a mental health professional, it may be helpful to focus on a diagnosis but I don’t think that it is always helpful for the client to search for a specific diagnostic label. Many people simply do not fit diagnostic labels and categories. People are unique and complicated and they may have many issues that do not match a specific diagnosis or set of diagnoses. I urge you to shift your focus on treatment and away from diagnosis.

You mentioned that you are in contact with a CPN (which I take to mean community psychiatric nurse since you are not living in the U.S.) and a psychiatrist, both of whom likely focus on medication as a primary treatment. Medication can be very helpful and has saved the lives of many people. What may be lacking in your treatment plan is that you are not addressing your anxiety, the compulsion to spend, depression, self-harm, PTSD, and the other issues you are struggling with. That is where your treatment needs to focus. Maybe you have attempted treatment for those issues in the past and did not include that information in your letter. From what I can tell you have yet to address those issues.

The solution is to alter your treatment to include therapy. All of the issues that you have written about can be addressed with the help of a competent mental health professional. If you find the right help then I believe you have an excellent chance of overcoming all of the issues you are facing. Thank you for your question. Please take care.

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Intense Feelings Cause Worry

by Kristina Randle, Ph.D., LCSW
written by Kristina Randle, Ph.D., LCSW

Since I was in high school I have suffered from depression. I always thought so little of myself and how can others possibly like me? I kept few friends and had quite a few boyfriends. I had a boyfriend for about 7 years. I always had this intense feeling that he was cheating on me when he was not with me. Deep down I knew that he wasn’t, as he loved me dearly. But I couldn’t shake this feeling. We had sex pretty early in the relationship, he was my first partner. I found out after that I was not his first and I felt betrayed. After that I went on to cheat on him several times, sleeping with a few different men, just one night stands. I didn’t think clearly, I didn’t even protect myself. Luckily through all of it I didn’t get pregnant or contract an STD. My partner put up with me for all those years knowing that I had cheating on him, thinking that I could be a better person. But I just couldn’t see myself as a good person.

Eventually after losing my job, I sat around for months not doing anything. He left me stating it was for my own good and I needed help. He still loved me, but he wanted me to get better. Years later I am now married to a wonderful guy. But I still get these intense feelings about things that should not matter. Such as, he likes a photo of a female celebrity on facebook. I get furious with him. Again, deep down I know I shouldn’t feel this way, but I can’t help it! When things are going great I feel so connected to him and want to feel that way all the time. But something so little just makes me snap and hate him. I don’t want to feel this way, I know it’s irrational. But I don’t know what to do.

I have always reacted very strongly to things. In school when I would get in trouble, sent to detention. I would start crying because I felt like scum, I felt like I was this worthless being. When I would make a comment to someone and they took it bad and hurt their feelings I would feel like I needed to punish myself for it. Sometimes by cutting myself, once with a broken bottle I found nearby. Even now at work, if I get in trouble for something that isn’t even that bad, I feel worthless, like I don’t deserve to live.

I can’t stand living with these intense feelings anymore. I want to be happy, but I feel like I don’t deserve it.

Your intense feelings might stem from jealousy. Individuals who experience jealousy are insecure. This insecurity comes from a lack of confidence. Jealousy is ultimately the lack of self-esteem. In relationships, it can be severely damaging. Jealous individuals see others, and in your case pictures of others, as being a threat.

You described yourself as being highly sensitive and there are times when you feel as though you are a “worthless being.” You also feel the need to punish yourself when you do something wrong. It’s also concerning that you sometimes don’t have the desire to live.

At the core of these issues may be depression. Individuals with depression do not think highly of themselves. They often see themselves as being unlovable and unworthy of love. They minimize their positive attributes and maximize their negative attributes.

These problems can be easily corrected with psychotherapy. Depression is highly treatable. Millions of individuals deal with self-confidence problems and have had great success with psychotherapy. I would highly recommend it. Please take care.

Dr. Kristina Randle

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Tell Family About Suicide Attempt?

by Kristina Randle, Ph.D., LCSW
written by Kristina Randle, Ph.D., LCSW

Back in December I hit a really bad depressive episode. My relationship with my girlfriend of 3 years wasn’t going well and work was highly stressful. I went into work that morning and got into a verbal altercation with a co-worker who never liked me. That was it, I was fed up with the world. I couldn’t take it anymore. So I went home and around 9pm locked myself in my room and attempted to overdose on my medication for diabetes and depression.

No one in my immediate family knows except my roommate, a friend, and two of my sisters. I’ve asked them all to keep it a secret. It’s been four months since I’ve attempted to take my own life. But unfortunately it was not the first. I’ve had a history of one previous attempt when I was 16. Since then I’ve battled to with my past and brought a lot of ghosts to rest. However, depression still haunts me. I suspect it will for the rest of my life. I’m on medication now. It helps for sure other than the occasional blues. But I recently lost my job and so the search for survival is on. (I haven’t told my family this as well) I feel ashamed and embarrassed and a failure. I’m 38 and still single and I rent. I’m educated and skilled. Just completed my MBA. But I feel like I only bring concern and worry to my family. I also feel conflicted because they always say I never let them in.

The problem is I don’t want to let them into this. I don’t want to drag them through what I did before.

Should you tell your family? That is a difficult question to answer. Will they understand? How will they react? Will they take it personally? One or several of your family members may blame themselves for your actions. They’re not likely at fault but sometimes family members lay the blame on themselves. Other questions to consider include do you have any expectations about their reaction? How would you feel if they began asking you questions about the incident? Would it bother you if they did? Would you feel comfortable answering those questions? How much are you willing to share? What is your relationship like with your family? You say you “never let them in.” Is this true and if so, is there a reason why not? These are all questions (and probably many others) that you may need to consider before you decide whether or not you should tell your family about the incident.

The issue of whether to tell your family is an important one but it’s secondary to the fact that you attempted suicide. You were stressed to the point where you actually took steps to end your life. This is a very serious matter. Life can be difficult but why did you turn to suicide as a way to deal with your problems? My concern is that you lack the necessary skills for coping and handling stress.

I am also concerned with the fact that you may be engaging in cognitive distortions. Cognitive distortions are essentially lies people believe about themselves that are not true. They are usually based on conventional wisdom. Unfortunately conventional wisdom is often wrong. People also tend to compare themselves to other people and come to a conclusion, usually negative, about themselves based on where they believe they “should” be in life. For instance, I suspect that you may subscribe to the idea that because you are 38, you should be married to the “woman of your dreams”, you should own a big, beautiful home and should have children by now. Because you have not achieved these things you may have concluded that there is something wrong with you thus leading you to feel depressed. You may even also believe that a person graduating with an MBA “should” be able to find a job and because you just lost yours, this is tantamount to being a “loser.”

My point is that maybe you’d like to have a job, own a home, be married, and so forth but because these things are not currently true it does not equate to you being a failure. Nor does it mean there is something fundamentally wrong with you. Maybe there are other explanations, beyond your control, as to why you’re not where you want to be in life.

For instance, with regard to being unemployed, the truth is that many people are losing their jobs through no fault of their own. The country is in a recession. Some political pundits suggest that we are practically in a Depression, much like during the late 1920’s and 1930’s. Furthermore, it’s been reported that college graduates are having an especially difficult time finding work because many companies are cutting back on hiring. My point here is that you should consider the very realistic possibility that unexpected economic conditions outside of your control make it difficult for you to find work.

You also mentioned that you are taking medication for depression but still have symptoms occasionally. In the very recent past you attempted suicide and that was not your first time. You did not mention whether or not you are in therapy. If you are not seeing a counselor please consider it. As I wrote earlier, my concern is that you lack basic problem solving skills. If you lack these skills you may be more likely to attempt suicide in the future. Suicide is not an effective problem solving skill. Studies show that most people who attempt suicide do not actually want to die. They want their psychological suffering to end and they don’t possess effective ways to deal with their pain. Counseling can greatly improve your coping skills. It can prevent you from resorting to the extreme measure of attempting suicide when you get stressed.

One last thing. It’s difficult to judge from your letter whether or not you are engaging in the kind of cognitive distortions I wrote about. If you are please know that you do not have to be “like” everyone else. Stop believing in the idea that you “should” be doing things at a certain age or time in your life. Be your own person. Live the way you want to live and try not to compare yourself to other people. You’ll be much happier in life if you focused on what’s appropriate for you and not what other people are doing. Please keep me posted on your progress.

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Mood Swings and Depression Caused By Birth Control?

by Kristina Randle, Ph.D., LCSW
written by Kristina Randle, Ph.D., LCSW

I have a few questions about mood swings, depression, anxiety, etc. First, the background: I have been taking hormonal birth control pills for 16 years. After the first 3-4 years I began having terrible mood swings; I would cry over nothing, develop into a rage that would simmer for quite a while, and occasionally throw things and punch walls and pillows. I talked to my doctor about it and he put me on an antidepressant. First we tried Paxil, but it made me dizzy and it also made my sex drive vanish. Then we tried Effexor XR and I felt better almost immediately. Years later I thought that maybe my brain chemistry had changed and I tried to go off the Effexor but it was horrible to say the least. I had brain shocks, terrible headaches where I couldn’t even move my head, and I was back to the crying and rage behavior. I was also in bed for a solid week with the symptoms. I was so miserable that I went back on the Effexor and now I feel fine again. My question is this: Could all these issues be related to being on the birth control pill for so long? Did I maybe only need the Effexor to handle the side-effects from the birth control? I’m also worried that I have irreparably damaged my brain with these chemicals and will never be the same off them. I’m wondering too because my husband and I would like to have a child within the next 2 years or so, and of course I’ll need to be off both meds by that time. Also, I’d really like to stop putting all these hormones and toxins into my body on a daily basis.

The only way to know if the moodiness is being caused by the birth control pills is to stop taking all of your medication. I am not recommending that you do this, especially without the assistance of your doctor, but it may be the only way to untangle the truth.

It is difficult to determine a cause and effect relationship between the birth control pills and the moodiness. Moodiness is a common side effect of birth control. It is very possible that if you were not on birth control you would not need the Effexor. It may also be true that your brain chemistry has been altered because of the birth control, although that would be very difficult to determine. The only way to know that information would have been to have taken a chemical or hormonal reading before and even then there would likely be no clear answer.

I would recommend speaking to your doctor about this issue. Perhaps you are not taking the correct type of birth control pills. Given the fact that you had such a strong reaction to them, alternatives should have been explored. A different type of birth control may have had an entirely different and more positive effect on your mood.

It might also be helpful if you met with a professional therapist for assistance with the moodiness. He or she might be able to determine if your mood swings are related to the birth control or part of an underlying personal struggle or mood disorder. I would especially recommend seeing a mental health professional when and if you decide to discontinue the birth control and antidepressants, to have children. During that process, there will likely be a psychological adjustment that you will go through and having a therapist to assist you during this process is advisable. If you would like to search for a therapist in your community, please consult this directory. Thank you for your question.

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Stuck in the past

by Daniel J. Tomasulo, PhD, TEP, MFA, MAPP
written by Daniel J. Tomasulo, PhD, TEP, MFA, MAPP

I am feeling extremely distressed. I saw a therapist for 3 months in US and now I’ve moved to a country where I can’t really afford a therapist and at the same time, I don’t trust the mental health system here. This is what I was diagnosed with in US:

1. ADHD

2. Depression

Here is what I’m having issues with:

1. Stuck in the past, I also get stuck in my emotions when someone is rude to me.
2. I was sexually molested for 5 years by my brother in law who also manipulated me and at the same time got my sisters (I have 2) against me in order to isolate me. I told my mom this a month ago now that I’m almost 27 and her response was more of shock + “why didn’t you tell me this before? ” and now when I tell her how hurt I am at her response. She says ” well, if you would have told me this earlier I could have done something. What do you want me to do now?”

This really makes me angry. Makes me feel like I don’t have anyone to support me. I also told my dad, who emotionally abused me at the same time I was being sexually abused. Its really hard opening up to my family, no one wants to discuss anything, its usually criticism or covering up emotions/situations for them.

My mom also said that no one would believe me, only my parents would, which I believe is true.

3. My dad is extremely sick. He is almost bedridden after a few strokes and that disturbs me. He was also very emotionally abusive and controlling while I was growing up. As a child, he was my favorite and he always supported and protected me, but the moment I became a teenager, he started emotionally abusing me, which really confused me and I ended up isolating myself because I was in a dysfunctional family where at the same time I was being sexually molested, had really mean sisters, had my parents always criticizing me and telling me how I really need to change because my behavior is bad (but it was because my sisters were always mean and they’d always go make a huge deal out of everything I did to my parents.. such as, if I didn’t want to share my cd with them, I was really bad and I didn’t have a heart- etc..) and I was also not allowed to have any friends at all. I was so depressed while growing up.

3. Now that I’m older, I can’t get away from the past. For years I carried the guilt and secrecy of the sexual molestation because I kept thinking I was stupid and it was my fault that this happened and now I feel angry that I got manipulated and I’m angry at my past, I’m also angry at the fact that I can’t build close relationships anymore, I’m too scared to.

4. I also just exited a relationship where my ex was emotionally abusive and with him, I started feeling like I was losing myself. I am a very logical person and whenever I found out things he was doing wrong he turned it around on me saying “think about it. Your logic is so flawed. What’s wrong with you?” He did this on many occasions and always had to make all decisions. He betrayed me and turned it around on me claiming me to be crazy. I actually did start feeling crazy, I started losing myself, and I didn’t know who I was anymore with him. I’m still getting over that relationship.

I also have anxiety issues, although they have gone down a bit after discussing with the therapist who told me I didn’t consider my feelings because I was taught to take care of others feelings.

Now I have moved in with my parents for a little bit and everything just comes all back in my head. I just can’t escape the past. IT’S KILLING ME, mentally, physically, and emotionally.

I am so angry at the following:

1. Why was I emotionally and sexually abused as an adolescent, it’s not fair!
2. Now I have problems with trust and intimacy, all because this man sexually abused me.
3. I can’t build relationships or close friendships because I was never taught to, in fact I wasn’t even allowed to during my teen years, I felt so isolated. I’ve lived in so much isolation it’s started to kill me inside now and I just don’t know how to change that. I don’t feel comfortable when someone genuinely likes me (as a friend), it feels very odd.
4. I was able to have sex before, but now I don’t think I like being touched. I’ve been avoiding it for a while… Actually, I’ve lost interest in bf/gf relationships but I’m not promiscuous either…
5. I feel like I have PSTD because I’m having lots of flashbacks from the sexual and emotional abuse but that also makes me angrier, why should I have all these problems because one psycho couldn’t control his behavior?!

PLEASE HELP!

I’m so angry at the past and at the effect it has had on me now that I’ve grown up. I feel so alone and isolated. I don’t feel like I can open up to anyone. My parents are extremely critical, they criticize everything in me, first I used to be super thin and I needed to eat, now that I have grown up and I weigh 150 for a 5’8, I need to lose weight– its like there’s always something I need to fix about myself. I’m too emotional, I’m too this and that.. everything is just wrong with me all the time. That’s how they make me feel. What also makes me angry is that they instill a lot of fear in me. Every time I try to do something they have fear about, where they’re concerned about me, they put it in me saying “DONT DO XYZ or THIS WILL HAPPEN. IT can happen, what will you do then”. UGH! I just wished I had some support! I feel terrible!

What a difficult set of circumstances and experiences you have to cope with. These are weighty matters and I will do my best to sort it through.

You are in India, and say that you do not trust the mental health system there. But there may be an even more important resource there for you to engage with. I would seek out a meditation teacher as a base for you being able to soothe yourself. A good teacher will be able to help you hold the uncomfortable feelings and allow your mind to settle. The studies on the value and importance of meditation are numerous. You are in a country revered for its meditative practices. If the psychotherapy is not okay for you, meditation with a good teacher will be helpful.

Secondly, since you also have a computer you can be Skype enabled. (For those unfamiliar Skype is a software application for computers that allows Internet-based free voice calls, instant messaging, and video calls to others on the platform. It also allows extremely low-cost calls from a debit account to landline phones. This is a particularly good service for long-distance international calls.)

This would allow you to call out to online therapists for a very nominal fee for the purpose of sorting through some of the issues you made mention of. See the banner at the top of the page. We also have an international referral base and there may be someone in your country you can ask for more direct guidance. Use the find help tab above.

This service can also help you stay connected with your social network you may have here. It will also help you as you connect to the online community. Please check our home page for a listing of our free support groups. We have over 160 and some are directly tailored to abuse and PTSD.

As with most things we have to use many tools to gain some peace. Here I am recommending you use tools at the opposite end of the spectrum. Go inside yourself to find the comfort and peace that is there waiting to be discovered and nurtured, and reach out with the vast resources of technology to the greater world outside.

Wishing you patience and peace,
Dr. Dan

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I Have Both Major Anxiety and Depression But Now It’s Causing More Issues with My Health

by Daniel J. Tomasulo, PhD, TEP, MFA, MAPP
written by Daniel J. Tomasulo, PhD, TEP, MFA, MAPP

I’ve recently been diagnosed with major anxiety and previously with depression. I’ve had to deal with these emotions most of my life, and I have been suicidal multiple times. However, that isn’t the case now. I was diagnosed with major anxiety because I went to the doctors with chest pains, which were resulting from the extreme stress on my mind. I also have a form of insomnia, so sleeping for me is an issue and always has been. I’ve been prescribed fluoxetine to help me with my condition and have been on them now for 2 weeks, however, I’ve started to notice some things.
I don’t feel, put simply, emotions. I’ve never really taken notice of it until now but looking back on previous events and situations, I’ve realized that I lack a lot of key emotions, from empathy to sadness to happiness. I don’t remember the last time I was happy or sad, I’ve never cried or broken down over events like family members dying or other things. But I only ever feel frustration, anger and such, negative emotions basically.
All my life I’ve sort of emulated the emotions of people around me, if other people were sad, I would replicate that, if they was happy, I would reciprocate by being positive in the situation. But I never truly felt anything. Years ago, my grandfather passed away, my father (who I now don’t talk to) told me first out of my siblings and all I said was ‘ok’. I didn’t react, whereas he told my brothers and they broke down. At the time I didn’t find that weird but now looking back it was odd.
The main reason for me doing this now is to get some clarity on my mind. Yesterday, I went to bed, and the next thing I know I was sat on my bed with a razor blade, with cuts on my arm and chest. The worst thing about this was j was completely unaware I was doing it, I remember doing it, but almost in the sense of a dream.
Basically, to summarise, I don’t feel anything but anger and frustration, my mind is constantly at full speed trying to calculate the way people are acting around me and I have to change my personality (if I have one) to reciprocate that person’s emotions.
Some clarity would be greatly appreciated. (From England)

We can be disconnected from our emotions for several reasons. The term for this used by clinicians is anhedonia. It is not a stand-alone disorder, but is part of depression and typically is part of a situation where the individual is under chronically stressful conditions. It means that there is a loss of interest in things you may once have been interested in. This sounds like what may be happening to you as you’ve explained that you have had chronic anxiety and depression. It also has been known to be both caused and helped by different medications. You can learn more about this by reading this blog by Psych Central’s Margarita Tartakovsky.

Perhaps the most important area to focus on is the blackout and cutting event. This is the greatest concern because the cutting sometimes is a way to feel, but if you are blacking out this creates a particularly risky situation. Some additional information is located here.

If you are not in therapy I think it would be particularly good for you to begin some form of individual therapy. While I believe any approach would be helpful — I think some of the experiential therapies (psychodrama, drama therapy, sand tray, or art therapy as an example) would be particularly helpful.

Wishing you patience and peace,
Dr. Dan

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I Don’t Want to Feel So Helpless Any More

by Dr. Marie Hartwell-Walker
written by Dr. Marie Hartwell-Walker

From a teen in the U.S.: Hello, I’m a freshman in college struggling with bouts of depression as well as some intense social anxiety. I’;m typically a pretty happy person and I’ve never gone to a specialist mostly because the thought of it makes my skin crawl just thinking about it as does doing a lot of things that involves meeting or speaking to people I don’t know to the point where sometimes I want to cry. Somedays are good and I can communicate with people without a problem but when it’s bad I can barely make eye contact with the people who are talking to me and I’ll fall back into nervous ticks like picking at my nails, rock, and or shaking my foot.

I just feel so uncomfortable and I don’t  know what to do. I’ve always had trouble talking to people even when I was a little kid and for the most part I’ve kept to myself my only consistent outlet being softball which I’ve played since I was 6. For a while now I’ve written off my feelings as a part of puberty and something that I’ll grow out of but it only seems to be getting worse. I’m not sure what it is but I’ve always felt like I’m a little off. In high school I never went out and partied with people and I’ve always thought it was dumb to do so. I haven’t done so much as to hold a guy’s hand let alone kiss one. I feel like socially I’m so far behind other people my age. I isolate myself from people when relationships get too intense and I avoid any type of attention positive or negative. I have a very active imagination and I often find myself getting lost in it ignoring the world around me going into autopilot while I’m doing things which helps me cope when I get in uncomfortable situations.

My parents are very supportive and my father has been pushing me to reach out to someone for a long time now. I just don’t want to feel so hopeless anymore. I want to understand what’s going on with me and why I get these feelings.

Thank you for reading this more than likely jumbled mess.

Thank you for writing. Your letter is not a “jumbled mess”. It is an articulate statement of very difficult feelings. Please listen to your dad. I know you know he’s right. You do need to reach out to someone. I also know how difficult that can be. The paradox of mental distress is that just when a person feels so stuck, the way out is to take the first step. In your case, it means making an appointment with a licensed mental health counselor who can help you determine what is wrong and make recommendations about how to become more comfortable in the social world.

Your letter is so well done, it can be a big help. Bring it to the first appointment or ask if you can mail it to the counselor ahead of time. Then you won’t have to explain what’s so painful to you on the first meeting with a stranger and the counselor will know where to start.

My guess is that things have gotten worse since you graduated from high school because the familiar faces and familiar routines helped you feel comfortable. Now that you are in college, you’ve had to start over. Please don’t scold yourself for feeling so distressed. Many people go through some version of the same thing when they have to deal with a new social environment. A positive side to this is that the change highlights the issues enough that someone like yourself faces it and gets the help they need.

I wish you well.

Dr. Marie

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Distinguishing Between Bad Times and Depression

by Kristina Randle, Ph.D., LCSW
written by Kristina Randle, Ph.D., LCSW

I have tried a little of over 12+ types of antidepressants, augmentations (like adding an anti psychotic), and now I am on Lamictal + Pristiq; turns out I had treatment-resistant depression. I’ve had the last four months “good,” compared to previous times, where my depression was out of control (this lasted for ~ 4 years or so, and because of personal & family problems, the last 2 were the hardest times, which included suicidal thoughts and a couple of overdoses – I still have those once in a blue moon). I also went to therapy, which helped me much, as I got a lot of support from my counselor -my family is still reluctant, but I know I need to treat my depression even if they don’t accept it. In the past, my treatment with medicine was just simply not working; to the point that my psychiatrist suggested Vagus Nerve Stimulation, but I wasn’t all for it, so I’m on this new combination.

My PCP tells me I look different, that I smile more, seem happier, and that sort of thing. The last time I saw my psychiatrist, I did tell him I felt an improvement, which he also saw on the last two appointments and made comments of it as well. He also warned me that some days were not going to be like that, and that it was okay. I’ve been keeping track of my moods about every week, and some days I feel really good, others okay, and some, not good at all – make me feel like I should take the whole day off. To the point where, once again, I feel that knot on my throat because I want to cry, and sometimes, just sometimes, I do. I’ve called my psychiatrist’s office twice this month to tell him I’m not doing so good lately, as this happens about twice per week or so. I’ve not gotten a call back about it, but what really bugs me is that how do I know that depression is not going to take over me once again? How can I tell that my meds are not working well? Or how often is it “okay” to feel that way?

Having had major depression for four years, well, I really had forgotten what it was to feel happy, and I still remember that when I first started to feel good, I was in this great-awesome-wonderful-happy-excited mood and attitude just 3.5 months ago that I hadn’t felt in such a long long time. My counselor and I decided, about two months ago, that it was okay to stop going to therapy, she had suggested prior to the last time, but I just wanted to make sure I was ready. She still told me that any time I needed help with my depression to call her again.

I know about a month ago, I felt really overwhelmed with all the extra-work I was picking up, like giving extra classes during the week and on the weekends, working on a paper I want to publish, and working on some presentations for summer (all four things different in topics and audiences). I thought it was a good idea, as it would keep me occupied and because my mental state is so clear, that now I can retain and process material that before I wasn’t able to (unlike the last four years that caused me to drop out of a PhD opportunity and go back to my hometown and teach at a high school, not that is wrong to do that, but it was such a great opportunity that it still feels bad to have stopped).

Amazingly, and not sure if I’m right to do this, I want to take a part-time job teaching at a college, but now, I’m a little puzzled as if this is the right thing to do. I know I want to feel good, but I don’t want for time to pass by and not do something to get back on the road towards that PhD, and it would be nice to include such activities, and since the last month I’ve been feeling troubled twice a week, I just don’t know if this is normal or I am losing it again. I’ll appreciate your input. Thanks.I would love to be able to fix things entirely and feel for certain that this man is in fact in love with me.

It seems as if you have made an improvement. Your therapist seemed to agree otherwise she may not have been okay with you terminating your treatment. Your PCP has also agreed. He noted specific positive differences in your mood and behavior.

Your concern, as I understand it, is that you’re not certain if your improvement is sustainable. You worry that your depression may return. The primary reason for your concern is that at least twice a week you experience depression symptoms to the point where you want to cry and you call the psychiatrist’s office for his or her advice.

This is a difficult question to answer. My concern is that you have stopped seeing your therapist. I would not have recommended this. Some people believe that because they are doing better they no longer need treatment. Improvement is a sign that the counseling is likely working but not necessarily a reason to end treatment. My sense of the situation is that perhaps you have discontinued therapy too soon. Here’s why I say this.

You are taking on many new responsibilities (e.g. working on a paper that you hope to publish). These new tasks are very important for your growth and development but they can be anxiety-producing. This would be true for anyone but especially for someone with a history of anxiety and depression.

You also want to return to teaching, which is good, but it may be too much for you at this time. Again, it is difficult to know if that is true because you lack an objective source to help you determine if it’s too much for you at this time.

The point is that you don’t want to overwhelm yourself. Taking on too much could potentially cause a relapse and you don’t want that. It is important to work at a pace that is reasonable and does not overwhelm you.

My recommendation is to return to therapy. Your therapist was supportive in the past. You improved when you were working with her. She can help you manage and assess your new responsibilities. She can advise you as to whether you are taking on too much, too fast. It would be helpful to have someone like this in your corner while you’re adjusting to your new responsibilities.

It is often best in a situation like yours to gradually decrease your therapy sessions. When all is going well with your weekly sessions, for a period of time, then moving to one session every two weeks would be the next logical step, then once a month and so on.

With regard to mood, it’s best to aiim for a normal fluctuation without extremes. One should not be manically happy or desperately sad.

Life is difficult. There will be suffering and there will be happiness. Some days will be better than others. In the words of Viktor Frankl “what never can be ruled out is the unavoidability of suffering.” We should expect it, learn to deal with it and perhaps even find meaning in it.

Moods can be affected by hormones. Hormones are something that we cannot control. Moods are also affected by a lack of sleep as well as other factors. Tired people may have trouble managing their moods. It is important to recognize this.

When you sense an oncoming bad mood, try to ask yourself the following questions:

  • Why am I feeling this way?
  • Is this a reasonable way to feel?
  • Do I have any reason to feel this way?
  • Is it logical to feel this way?

Some of these answers may help you to better understand why you feel a particular way. When a negative mood arises, try to eradicate it using logic. Don’t allow yourself to be in a bad mood if there is no reason for it to occur. Logic will not work every time but it may prove helpful some of the time. If there is a legitimate reason for a negative mood, try to work through it to diminish it. What’s good is that you have begun to record your moods. This may help you to better understand them when they arise. You may see a pattern.

I hope this answer helps in some small way. I wish you luck in all of your future endeavors. Thanks for writing. I wish you well.

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I’m Not Sure I Can Recover & I Don’t Know What to Do

by Kristina Randle, Ph.D., LCSW
written by Kristina Randle, Ph.D., LCSW

Hi, I’m 26 years old and have struggled with depression and anorexia since I was 13. In the past 3 years, my anorexia has got particularly bad (before, I managed to maintain a BMI of 15) after an eating disorder (ED) admission which triggered some very distressing memories and I was consequently diagnosed with PTSD.

My anorexia has become a coping mechanism and every time I’ve got to safer weight, my depression/ PTSD gets worse, particularly when trying to address them in therapy. I do want to be well but I’m caught in a cycle and have no idea how to get out of it. I was sectioned in 2018 for a year after my BMI dropped to 11/12 and then got transferred to a residential house for people with severe and enduring EDs. I’ve got to a BMI of 15 but I’m already slipping backwards and am unable to work on my PTSD due to the COVID-19 situation and my therapist thinks I won’t cope mentally due to being trapped in a house with 4 other patients plus up to 3 staff (I’m very hypervigilant). I’m so tired of it all and just want to feel better/ happier and not have to feel so on edge and not have nightmares constantly.

I’m feeling pretty hopeless and don’t know how to keep going. Any suggestions? Can I ever get out of this situation?

I understand that this is very difficult situation made even more challenging with the pandemic. Much like yourself, people are feeling more stressed than usual. People are frightened of becoming sick, losing their jobs, and not being able to leave their homes. A Newsweek article recently reported a 34% increase in the number of anxiety medications and other mental health medications being prescribed. People are clearly struggling.

Insomnia and nightmares are also problems for many people. One Harvard University professor collected approximately 6,000 dream samples from over 2,400 people. She was able to collect such a large sample of dreams because of the increased number of people discussing their pandemic dreams. Many of them are dreaming about being sick with the virus, being in crowded public places without a mask or inappropriate levels of social distancing. Others dream of losing control, and some are simply nightmares. That suggests that people are struggling, missing out on the things they are used to, and reacting to the stress of this unprecedented time in our lives.

In some respects, much of what you’re experiencing is consistent with what many others are experiencing. Unfortunately, you’re experiencing it on top of the other issues you mentioned including anorexia, depression and PTSD. Understandably, it can feel overwhelming but there is hope for you. All of the disorders you have are treatable. It may take some time, and it may take you finding the right therapist or type of therapy but it is worth trying. There is hope for people who have these disorders.

You have a therapist now and is important to evaluate whether or not she is the right therapist for you. In addition, it’s important to evaluate your current type of therapy. Are you in the therapy you need to be in? Are you feeling at least slightly better after each session? Are you working with a therapist who has successfully treated other people with similar problems?

As you may already know, anorexia is a complex disorder. It is thought that environmental and psychological factors influence the expression of genetic risk that leads to the eating pathology. The most current research would suggest that anorexia is a brain-based disorder that overlaps neurobiologically with anxiety disorders and addictions. Studies have indicated, regarding treatment, that eating disorder-focused therapy is superior to individual therapy among adolescents. It is less clear what treatment modality works best with adults. One novel treatment that is showing promise is cognitive remediation therapy (CRT). This particular therapy aims to improve cognitive flexibility and holistic information processing. Another potential promising therapy is exposure therapy for anorexia. Exposure therapy involves fear conditioning, by systematically and slowly exposing one to one’s fears in order to overcome them. Other approaches involve medications such as olanzapine which can increase one’s appetite.

The most important thing for you at this time is not giving up and realizing that there is hope for you. It might be helpful to read the stories of individuals who have overcome anorexia, to learn more about what they did, and their mindsets. It may also be helpful to work with your therapist to adjust your medication during the pandemic as well as developing better coping skills. The more coping skills you have, and the more flexible you are in your thinking, the easier it will be to endure this difficult time.

I mentioned flexible thinking and coping mechanisms because I think they’re vitally important in overcoming anorexia. The fact that anorexia has become your coping mechanism suggests that a modification is desperately needed. The most concerning aspect of anorexia is the physical toll it takes on one’s body. It has the highest mortality rate of all psychiatric illnesses. Thus, it’s important to develop alternative strategies for dealing with stress, and there are many of them. You have to be willing to use them which means being willing to tolerate the discomfort that comes from not giving in to your more habitual coping mechanisms (i.e. anorexia).

Finally, you might find it useful to watch the show Obsessed. It used to be on the A&E Network but most of the episodes can now be found on YouTube. Obsessed focuses on individuals with obsessive-compulsive disorder. You don’t have obsessive-compulsive disorder however, I think there are many similarities between OCD and anorexia, specifically the inability to be cognitively flexible and the unwillingness to tolerate uncomfortable feelings. Part of what makes the show potentially helpful is that they demonstrate how exposure therapy can work quite effectively for individuals with OCD. It might help you to see what it’s like for people to tolerate uncomfortable feelings. An important element of exposure therapy is that even when someone feels uncomfortable and excessively anxious, those feelings eventually diminish and subside. It’s helpful to see firsthand that even when feeling overly anxious, eventually those feelings will subside.

To answer question directly, yes you can overcome this situation. Please don’t give up and keep trying, until you find something that works for you. You might also try treatments that are focused more on depression and/or PTSD. Perhaps, if those issues are dealt with, you might have an easier time overcoming the anorexia. Good luck and please take care.

Dr. Kristina Randle

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I Just Can’t Seem to Be Helped

by Kristina Randle, Ph.D., LCSW
written by Kristina Randle, Ph.D., LCSW

I have never been diagnosed with anything, but I’ve been dealing with a lot of things recently, and it impacted my everyday life greatly. People started noticing and they tried to help. My friends tried to do as much as they could but, us all being high school students and them having their own life to live they eventually stopped talking about it. I live alone with my mother and we have a very bad relationship so I didn’t really turn toward her for help. In the end it was just my partner that stayed by my side and did everything he could to make my life a bit easier.

One of the big problems is that I have a tendency not to feel things when I’m upset, and it can last for months or even years at a time, so when I’m in a bad place and he tries to help, and he goes out of his way to ease my burden even if it’s just a little, and I know that my non-reaction to all of his sacrifices is hurting him. He feels worthless because no matter how hard he tries I just don’t seem to be able to accept his help.

I know that I’m hurting him by just doing nothing and being empty but I just can’t snap out of it. No matter what he says to cheer me up, or when he tells me that I’m beautiful and that I’m the best things to ever happen to him, I just listen and think “Yeah, we both know that’s not true”.

I feel like I just can’t be helped, like it’s just plain impossible. I know exactly what’s wrong and I don’t do anything about it to the point of hurting the one person that I love. I keep destroying myself and I can’t seem to care, even if I know that I should care and that I should get professional help.

I feel like an empty shell, even typing this I don’t know if it’s sincere of if it’s just me pretending to care. I really don’t know what to do and it doesn’t bother me at all, I don’t even know what I’m expecting of this. I won’t say “help me” because really I feel nothing, but I don’t want my partner to suffer because of me. What can I do about that?

The symptoms you have described may be consistent with depression. People with depression often use similar words and phrases to describe their experiences. They feel numb. Their friends and family try to help, without much success. They can’t get out of bed. Every day seems worse than the day before. They feel like a burden to people, and so on. Depression can feel like a never-ending cycle of sadness and hopelessness.

Depression most assuredly feels bad but it is treatable. In fact, it may be one of the most treatable mental health conditions in the world. It’s only untreatable when people fail to seek help. Great treatments are available for depression and virtually all mental health conditions. Many people simply don’t seek help for it and suffer needlessly. Don’t make that mistake.

It’s also important to note that I’m not diagnosing you with depression or any other condition. Diagnosis over the Internet is impossible. Thus, it’s important for you to consult, in-person, a professional who can assess your symptoms and determine what may be wrong. They would be in the best position to help you.

Let’s further examine the idea that you cannot be helped. You’ve never consulted a professional, yet you have concluded that you cannot be helped. Logically, that’s a very inconsistent and irrational position.

Imagine, for a moment, that you had broken your leg. In this scenario, you never go to a doctor. You simply lugged around your broken leg and tolerated the immense pain. That’s essentially what you’re doing by not having sought treatment for the symptoms you have described. You are simply living with your emotional pain, never having sought professional help and subsequently concluding that you are a hopeless case. Nothing could be further from the truth.

When you recognize that something is wrong, and you’re not feeling good, you should always consult a professional. There’s nothing to be ashamed of. We all struggle from time to time and need the assistance of experts. Mental health treatment is available if you ask for it.

Regarding your partner, neither of you should have the expectation that he could cure these problems. As a layperson, he does not have expertise to effectively treat your symptoms. You would not have expected him to fix a broken leg because everyone knows only a trained physician, with expertise in orthopedics, could do that. Apply that same logic to mental health problems. Friends and family can offer you support but they cannot treat mental health problems. They are simply not trained to do so. Mental health professionals have the right expertise to help you.

I would highly recommend that you consult a mental health professional. If you don’t feel comfortable asking your mother, then perhaps another relative could assist you. Another option is to ask your family doctor or the school guidance counselor for their assistance.

Your symptoms are highly treatable if you are open and willing to seek help. I hope that my letter has convinced you to seek treatment. Please take care.

Dr. Kristina Randle

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Depression & Suicide

by Kristina Randle, Ph.D., LCSW
written by Kristina Randle, Ph.D., LCSW

Don’t know where to start so… I’m a 28-year-old male have no kids never been a relationship and don’t have a really have much else. Surprisingly though I’m actually very interested in psychology and can see people problems including my own, but still have I hard time continuing with my own life. Everything I seem to want or achieve in life just doesn’t happen from goals in life to the simplest whatever. Just doesn’t seem to work out for me. I don’t really have friends and I feel like the people I do have around me aren’t really there. One of two problems I come to discover is my mother. I come to realization that she’s a big problem to my mental health. She never really pushed me or ever been supportive anything I do. So, I’m not very affectionate or close to anyone. Another is I have a twin brother who I have nothing in common with so i unconsciously tried to be the opposite in any way I could. I have lost interest in continuing life if I can’t even think about something that just won’t happen and it just frustrating. I’m 28 never had a girlfriend, no job, still live with my parents and don’t really own anything. I thought about suicide since maybe my early 20’s. I’m really just done with life and feel like if my life is just failure after failure that I can’t even think of whatever it maybe then what’s the purpose.

Ending your life is not how you should try to solve this or any problem. It should not even be a consideration. You are assuming that because you haven’t identified your life’s purpose that you never will. That is a flawed assumption. It could simply be, as it is for many people in the world, that you haven’t found your purpose yet; it does not mean that you never will or that you should stop trying.

Finding one’s purpose is usually not a straightforward process. It involves soul searching and experimentation with an open mind. It can be enriching, joyful and glorious. It might even be said that it is our purpose in life to find our purpose in life. It is perhaps our reason for being.

You stated that your life isn’t going as planned. Perhaps that is because you have made incorrect choices. Many people make life choices that are not in their best interest often because they are misguided about what they think will make them happy. Abraham Maslow, in writing about the process of self-actualization, believes that “the average normal, well-adjusted person often has not the slightest idea of what he is, of what he wants, of what his own opinions are,” in part because they have not uncovered their own wants and desires. You can change this with conscious self-exploration and counseling. A good therapist will examine your life and assist you in making the proper adjustments. Counseling can help you to achieve your life goals more efficiently.

People often erroneously believe that they’re supposed to know how to solve all of their life problems. If they can’t, they feel weak, helpless or like a failure. The reality is that we are not born knowing how to do these types of things. There is no shame in not knowing. When we know that we don’t know, we must look for those answers in books, mentors, education, and counseling, etc. Once we learn what we need to know we can then use that knowledge to make better choices. That is how we learn, grow and change.

It’s common for people who are depressed to compare themselves to other people and then judge themselves as a failure. Depressed people often see everyone else as being happy and successful but their perception is skewed. At some point, everyone struggles in life. Thankfully, treatment is available and can assist you in making the necessary life course corrections.

Be kind to yourself. Do not be judgmental and harsh. That can often be easier said than done because we live in a culture that is competitive, focused on status and the accumulation of material goods and wealth. Many people are misguided about what they think will make them happy and are suffering as a result.

In the meantime, you might try volunteering and being useful to others. Studies show that helping others can be deeply spiritually rewarding. Volunteerism is not a treatment for depression per se but in the short-term, it could help you in positive ways.

If you’re open to it, contact a local therapist. Try asking your primary care physician for a referral. Alternatively, you can use the “find help” tab, at the top of this page, to search for a good therapist. I always recommend contacting four to five therapists. Contact them and discuss these issues over the phone. Choose the one with whom you feel the most comfortable and then meet in person. Finally, if you cannot protect yourself, contact emergency services. They will keep you safe and ensure that you receive the proper treatment. Please take care.

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A Lot of Factors Seemingly Contributing to a Poor Living of Life

by Kristina Randle, Ph.D., LCSW
written by Kristina Randle, Ph.D., LCSW

As a child I loved reading and drawing. I was a smart student, but I thought the world was against me. I was picked on because of my skin color. And I think I must have been a bad child because I was hit a lot, but other than not participating in physical things, I don’t remember being bad.

I am now 32 and still feeling that the world is against me. I try to work hard everyday, I try to make friends with other people, I don’t drink or smoke or take drugs, and I keep generally physically healthy. I have had a tough relationship with my family as far back as I can remember. I also have a tough time making friends. People know me and they leave. I am generally not a happy person, I don’t think I know what true happiness feels like. I mostly feel worried, angry, nothing, sad, anxious, etc. I’ve fallen into severe depression a few times, and I’ve also been raped a number of times. I don’t feel like I’ve not worked as hard as others, however I have made very little progress in all areas of my life in comparison. I see everyone progressing in some aspect of life at least whether its meeting a life partner, or having a descent career, or having a great social life. I seem to be going backwards and no-where in all of these aspects no matter how hard I try.

Also in the last 4-5 years, my memories are fading quickly, and I do not remember much anymore. My brain is always numb and foggy, I tire quickly, it takes me forever to do anything, I get frustrated and give up so easily, I cannot focus, and I no longer care how I look.

I know I am hurting the few people still around me by these changes they see in me, and so they yell at me and berate me in the hopes that I will turn things around, but I feel like a ship at storm and am flailing. I feel like something must be very wrong with me, but I have no clue what. Any insights you may have would be greatly appreciated. Thank you.

There are two main areas that I would like to focus on in my response to your question. The first is that you have described symptoms that potentially indicate depression. You have had episodes of “severe depression” but there is no indication of treatment. The people trying to help you may be inadvertently making things worse. No wonder you feel like a “ship at storm.”

Sometimes our loved ones inadvertently do more harm than good. Family and friends can offer support and love, but they are not trained mental health professionals. We should not expect them to know how to solve complex life problems.

Depression should be treated by mental health professionals. A therapist will offer evidence-based ideas and solutions. They will not yell at you or berate you. They are knowledgeable, non-judgmental, kind, and supportive.

The second area of focus involves your thinking. You seem to be comparing yourself to the ever-abstract and ill-defined “other people” in society. It is simply inaccurate to compare yourself against people whose life circumstances you do not know.

Further complicating these matters is that many people have expectations about how they believe life is supposed to be. They compare themselves against a set of abstract standards and deem themselves as not being good enough. They incorrectly assume that other people are doing better than they are which naturally leads to feelings of inferiority, and so forth. This type of thinking is particularly prevalent among people with depression.

Social media adds to the struggle. People on social media often appear to be living perfect, trouble-free lives but that is far from the truth. It’s an illusion. Avoid overgeneralized thinking traps.

Treatment can help you to address these problems. Choose a therapist who specializes in cognitive behavioral therapy. It’s the best type of treatment to address both depression and the thinking errors that accompany depression. Once your symptoms are treated and your thinking becomes more realistic, you will feel better and less stressed. Please take care.

Dr. Kristina Randle

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How Can I Not Pass On My Eating Disorder?

by Kristina Randle, Ph.D., LCSW
written by Kristina Randle, Ph.D., LCSW

I need help on how to raise my daughter while struggling with Anorexia. I’m a 26 year old mother to a 7-year-old girl. Her father and I separated and eventually divorced when she was 2 years-old. She has always been under my primary care. I was diagnosed with Anorexia when I was 14 years old (I also have diagnoses of Borderline Personality, Depression, Self Injury, and PTSD). I have been inpatient for short stays, completed day programs and been in individual therapy. I have also been on over 10 different medications. Recently my eating disorder has flared up. I have for the most part stopped self injuring (I slip occassionally, but always get right back on track). My daughter is now at the age where “I’m not feeling well” isn’t going to cut it and I know that. I want nothing more than to prevent her from following my footsteps down this path of physical self destruction. I have good days and bad, but no health insurance and can’t afford to get the treatment I know I need to truly recover. I eat dinner with her every night and have been doing well with keeping that one meal down. I don’t eat anything but the meal usually. I go to the gym as often as I can and run 5-10 miles with no food in me and only 4 oz of water allowed. I am spiraling and I don’t want her to follow. I love her and we have a great relationship, but I need to know how to talk to her or not talk to her about this issue and what I can do until I reach recovery to lessen the likelihood that she will embrace this disorder that I can’t seem to rid myself of. Please help.

You have asked a very good question. It is important to acknowledge that you are in a challenging situation. You are not yet stable but you recognize that it’s important to teach your daughter how to be stable so that she does not follow in your footsteps.

One of the ways children learn to behave is through modeling. This means that they learn how to behave usually by mimicking the behavior of their parents. This is also true with regard to developing a relationship with food. If your daughter sees you eating only small amounts of food then it’s very possible that she will model your behavior. Generally, the best way to show your child how to develop a healthy relationship with food is to model it for her.

You are currently not in treatment because you do not have health insurance. Unfortunately, many people are in a similar situation. Even so, there are ways to access treatment that are affordable and in some cases, free. Community mental health centers usually offer sliding scale fees or free services based on income. Your daughter may also be able to be seen by a therapist at a community mental health center. Perhaps the two of you could try family therapy. The therapist can help you be a better model for your daughter in terms of eating. He or she could also advise you about how to prevent the development of the disorder in your daughter. You may find family therapy to be very effective.

The bottom line is that you need to be stable for your daughter. That is going to be the best way to prevent the development of any mental health disorder in your daughter. When instructing passengers before a flight, the flight attendants prepare passengers in the event of an emergency. They advise parents to first secure their oxygen mask before attending to their children. Why? Because they recognize that a parent who can’t breathe, who essentially is unstable, cannot effectively help their child. The point is that to effectively help your child you first need to be well yourself.

You clearly are a caring mother who’s worried about her daughter. Accessing effective treatment needs to be your priority. Your motivation could be that you do not want to pass an eating disorder on to your child. The best way to find a community mental health center in your area is to search through the white or yellow pages in the phone book. Call different agencies in your community and ask where you could find help. Thank you for your question. I hope you’re able to find the help that you need.

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Personality Disorder? What’s Wrong with Me?

by Kristina Randle, Ph.D., LCSW
written by Kristina Randle, Ph.D., LCSW

I’m feel like there is something seriously wrong with my head and I just don’t know what it is? I’ve researched a lot of different mental disorders and I can relate to a lot of the symptoms of so many of them. When I was in 4th grade I was diagnosed with ADD and I’ve have had on and off depression, disordered eating habits, and anxiety since then but I was diagnosed with depression and anxiety 3 months ago. Lately I have been feeling very disconnected and can’t stop zoning out, when I’m not zoned out my vision is distorted. Everything looks like its shifting, breathing, certain things pop out a lot, and when I read text it waves and spirals into itself. Sometimes when I walk I feel the curve of the earth and everything to the side of me looks downhill. Kind of like tripping but not. I did do LSD twice about 5 months ago but I’ve only been experiencing these symptoms for 2 or 3 months so it’s not because of the acid. I question reality and get confused about the concept of time and sometimes I completely forget who I am. Also been having bad insomnia and strange sleep patterns. I’ve been impulsive and doing things that I regret later; smoking a lot more than usual, drinking all the time and trying other harder drugs like Xanax and coke(once) but thats weird for me because I’ve always thought of myself as weed only. I’ve also been hooking up with a lot more guys which is weird for me because I’ve always been kind of afraid of and have never been in a relationship and am very self conscious but I keep hooking up with guys I don’t care about. I also just really hate my personality. I try to seem unique but really I have no personality, I’ m nothing but a bunch of stolen identities. When I ask someone to hang out and they can’t I get extremely hurt by that to the point of tears and think that everyone thinks I’m annoying and that girl that I think is cool and I wish people could see me the same way as people see her knows that I’m copying her. Sometimes I’m afraid to go on the deck because I think I can’t control myself and I might jump off.

It’s not possible to determine a diagnosis over the Internet. The other issue is your age. Some mental health professionals are reluctant to diagnose teenagers with a mental illness because it is a turbulent time, both developmentally and emotionally.

When mental health problems are a concern, it is especially important to refrain from using drugs and alcohol. They can negatively impact your mood and personality. They could make your symptoms worse or perhaps may even be causing them. Therefore it would be in your best interest to stop using drugs and alcohol.

It was your opinion that you don’t possess a “unique personality ” and that you are a conglomeration of a “bunch of stolen identities.” What I think you might mean is that you are behaving in ways that you believe other people want you to instead of just being yourself. That could stem from low self-esteem.

Lack of self-esteem might also be evidenced by your “hooking up with guys [you] don’t care about.” You might not be so willing to indiscriminately “hook up” with these people if you felt better about yourself.

You have received different diagnoses. This would suggest that you have been evaluated by a mental health clinician. It’s good that you were in contact with mental health professionals, but you did not mention being in treatment. Counseling is the ideal treatment for the problems you have described. Medication could also help with your symptoms.

Erik Erikson is a famous and well-accepted developmental theorist. He talks about a stage that people go through when growing up. It is called identity vs. identity confusion. In essence he is saying that a teenager must go through a stage where they will find out who they are. They need to find their identity. You can read about this and see if it explains some of your feelings.

The symptoms you described require treatment. Contact a mental health professional and ask for his or her assistance. What’s most important is treating your symptoms with counseling and if necessary, medication. Please take care.

Dr. Kristina Randle

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Boyfriend with Depression

by Kristina Randle, Ph.D., LCSW
written by Kristina Randle, Ph.D., LCSW

Recently I fell in love with a boy who I think has a depression. He’s 17 years old and doesn’t have any plan for the future. He doesn’t like going out neither with his friends nor me and the only thing he wants to do is to stare at one place for long time. The worst thing is that after a week that we kissed each other he decided us to be just a friends and I didn’t want this. So, I told him that he had 2 choices: 1: to broke up with each other completely 2: to be my boyfriend. Then, he told me that he could’nt make a decision and I understood he can’t leave me. So, I gave him time. But I want to help him because nothing will make him happy, sad or even angry. He did suicide for more than once but I don’t know how he is alive now!!! 2 things that I should mention 1st is that he had too much sex in his life and the 1st one was when he was 12 means he wasn’t sexually mature. The 2nd one is the fact that he has some problems among his family too. He doesn’t believe that he has a problem and he should visit a doctor. I really want you to tell me what to do in order to help him.

It is difficult to watch someone you care about suffer. It’s even more difficult when they resist getting help. It can be a helpless and frustrating feeling.

Your boyfriend may in fact have depression. The biggest concern is that he has attempted suicide twice in the past. This is a sign that he feels hopeless and lost.

The experience of depression for a teenager can be very intense. Teenagers often feel that there’s no one they can talk to and no one will understand their situation. Because of this, they are often hesitant to speak to their parents and even friends. They may shut down completely. When they feel as though there’s no solution, unfortunately, they too often come to the incorrect conclusion that death is the only answer. Perhaps it was this type of thinking that led to his past suicide attempts.

The message you want to send to your boyfriend is that there are many alternatives to suicide. You want him to know that depression is a very treatable illness. Millions of people suffer from depression and they are helped by mental health professionals. There are treatments that exist but it’s going to require action on his part. It means that he will have to agree to be seen by either a physician or a mental health professional. Stress to him not only the importance of getting help, but that treatment works.

I want to make you aware of the possibility that even if you plead with him to seek help, he may decide against it. There are a few exceptions but in most instances, you cannot force someone to seek help. The only time that you can force someone into treatment or the hospital is when they are in imminent danger of hurting themselves or someone else. That means that if a person states that they are intending to kill themselves or another individual they can be admitted to a hospital against their will. Generally this is the only time an individual can be forced into treatment.

You can also educate yourself about depression and suicide. Here is a link to depression-related information on Psych Central’s website. This may help you understand what your boyfriend is feeling. I would also suggest that you consider contacting his parents about your concerns. You should also speak to your parents about how to handle this situation. They need to know that you’re dealing with a very serious problem. As I mentioned before, the concern is that your boyfriend has a history of suicide attempts. One predictor of future suicide attempts is past suicide attempts.

Please do not feel as though this is your problem and that you have to find a solution for it. Even if you request that your boyfriend seek help, he may choose not to. That is the reality of the situation. At this point, there is little that you can do. He needs more help than you can offer. He needs to see a professional. Please speak to your parents for support and don’t deal with this situation alone. Garner as much help and support for yourself as possible and perhaps your boyfriend. Thank you for your question.

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Am I Going Insane?

by Dr. Marie Hartwell-Walker
written by Dr. Marie Hartwell-Walker

From a teen in Serbia: My psychological state was never quite alright ever since I entered puberty it seems. It first all started with a case of mild depression as a result of having some existential dilemmas and coming face to face with the uglier face of this world for the first time. Slowly but surely this feeling of dread started creeping into me, and I completely shut myself of from the rest of the world somewhere at the age of 13, spending my days in the darkness of my room along with a book.

I don’t want to go too deeply into how that all progressed, so let’s just skip to my current state. My “depression” from these past few years at least rarely surpassed the borders of sanity. It still felt like I had my grip on reality and that my brain still functioned alright when it came to some basic human functions, it still felt like everything was somewhat compact and in it’s place although that immense feeling of dread was never ever leaving me. But today, I… I don’t even know.

It’s like everything has fallen apart at the very basis of my psyche. Nothing functions normally anymore I… I can’t memorize as I used to. My thoughts, it would be an understatement to say that they are only completely unorganized – they’re absolutely ludicrous. My identity has become some sort of a mystical term I do not believe in anymore. It’s become incredibly tough trying to organize this chaos constantly, with no end to it.

I’ve locked myself away in my room. Socializing has become harder for me than ever and I just can’t bring myself to go through such torture anymore. Being awake becomes more and more torturous by every passing day. And even in my dreams I can’t find comfort because I constantly have nightmares, nightmares like I’ve never had before. With gruesome pictures of hell. I’m scared. I’m scared. I’m tired.

I understand why you are frightened. I don’t understand how it is that you’ve been able to isolate yourself so severely since you were 13. You didn’t mention what your parents have done or not done about your behavior. I hope you are keeping them informed of your feelings and that they can be supportive and take the needed steps to get you the help you deserve.

Without more information, I have no way to determine if what you are experiencing is the result of a sleep disorder (which I suspect is at least part of the problem), social anxiety, depression or some other problem. I do know that you can’t handle the situation by yourself. You need help. You need a proper evaluation of your sleep habits, your diet, your general physical health and your mental state.

The place to start is with your regular primary doctor. I believe that Serbia has been working on reforming mental health services for almost 20 years. Your doctor will be able to refer you to the appropriate professionals.

Adolescence is tough for a lot of young people. You are certainly not alone in withdrawing into your room. But feelings such as you describe should not be ignored or untreated.

You’ve already lived with this distress for 3 years. There is no need to continue feeling so terrible and so afraid. Please come out of your room and out of your own head and reach out for the support that is available to you.

I wish you well.
Dr. Marie

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Needing Help

by Kristina Randle, Ph.D., LCSW
written by Kristina Randle, Ph.D., LCSW

I’m a 15-year-old female. The past 6 months of my school life and sleep schedule have been deteriorating to me physically, but recently it seems like my emotions have been going haywire too. I used to get 8-9 hours of sleep nightly, but have now gotten 4-5 hours of sleep for the past 5 months and have been holed up in my room doing homework more than ever.

I get irritated with everyone much more easily, and find myself sighing and glaring at everyone and everything. I didn’t tell my friends because I don’t want them to be worried about me either. I think of death almost constantly, and it happens out of nowhere. I’m afraid of death, but have had increasing thoughts of killing myself and how I could do it. I don’t believe I’d act on it, but I still get scared. I haven’t self harmed since I’m too afraid to hurt myself either.

My (12 yrs divorced) parents believe I’m overreacting, and refuse to take me to a therapist or mental health professional. (one of them has bipolar disorder and extreme anger management issues too) I have no money to take myself or get a proper evaluation.

Am I overreacting about this?

Much thanks.

You’re not overreacting. Whenever you think something may be wrong, you should take action. Not everyone does, but they should and your instinct to ask for help is a very good one.

Part of why you may be feeling more irritable is a lack of sleep. People are more irritable and emotional when they do not receive the proper amount of sleep. As a teenager, ideally, you should be receiving a minimum of nine hours of sleep. If you’re not getting the amount of sleep you need, you will be less sharp, and more emotional and irritable.

What’s most concerning are your thoughts of suicide. Suicidal ideation is not necessarily a side effect of lack of sleep. It may be exacerbated by a lack of sleep, but it is not generally caused by it. It might suggest that something else is wrong such as depression.

Because your parents are reluctant to take you to a therapist, one way around this may be to consult your school guidance counselor or another trusted faculty member. The more direct you are with them, the more they will be able to assist you. They may also be able to speak to your parents on your behalf and convince them that mental health treatment is the solution to this problem.

It’s good that you are proactive and are attempting to seek treatment. The school guidance counselor will likely be able to assist you with this problem. If not, and you are still thinking about suicide, do not hesitate to contact emergency services. The phone number for the National Suicide Prevention Hotline is 1-800-273-8255. The crisis text line information is the following: text HOME to 741741 in the United States. They will know how to keep you safe. Please take care.

Dr. Kristina Randle

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